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基于单剂量静脉注射钆后3D-FLAIR序列的内淋巴积水磁共振成像研究

[Magnetic resonance imaging study of endolymphatic hydrops based on 3D-FLAIR sequence after single-dose intravenous gadolinium injection].

作者信息

Lin Y, Wang Z Y, Zhang Z R, Zheng X, Chen Q H, Wang H J, Hao X P, Li Y X, Xian J F, Yang B T

机构信息

Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2019 Jan 29;99(5):333-337. doi: 10.3760/cma.j.issn.0376-2491.2019.05.003.

Abstract

To investigate the visualization of endolymph in patients with otogenic vertigo by intravenous administration of single dose of gadolinium contrast agents and magnetic resonance three-dimensional fluid-attenuated inversion recovery sequence (3D-FLAIR MRI), and further assess the extent of endolymphatic hydrops. From Beijing Tongren Hospital of Capital Medical University between October 2017 and June 2018, 30 patients (16 males, 14 females) with unilateral otogenic vertigo were involved in this study, with the age of 30 to 68 years, mean age of (53±10) years. Eight hours after intravenous administration of single dose (0.1 mmol/kg, body weight) of gadopentetate (Gd-DTPA), 3D-FLAIR sequence was performed in 30 patients. The location of endolymphatic hydrops was observed and then the degree of hydrops was quantitatively elevated by two radiologists. The consistency test was used to analyze the location and degree of endolymphatic hydrops in the two radiologists and the paired -test was used to compare the difference between the affected and healthy side of endolymphatic spaces of the patients with otogenic vertigo. In 30 patients, the gadolinium distributed in all parts of the perilymph inside the inner ear, and can accurately outline the boundaries of the peri-and endolymph. Twenty-six patients (26/30, 86.7%) were found to have unilateral endolymphatic hydrops, including 18 mild hydrops, 8 significant hydrops. The two radiologists had a very good agreement on the assessment of endolymphatic hydrops(=0.864, ICC=0.959). In the 3D-FLAIR MR images of 26 patients with endolymphatic hydrops, the saccule (26/26, 100%) had a higher rate of hydrops than the cochlea and utricle(16/26, 61.5%; 14/26, 53.8%), and two radiologists had a very good agreement on the location of endolymphatic hydrops(=0.820). Moreover, there was a significantly statistical difference between the affected and healthy area of the endolymphatic space in this study (0.01). The technique of 3D-FLAIR MR imaging through single dose intravenous gadolinium injection is feasible, which can estimate endolymphatic hydrops in patients with otogenic vertigo, and accurately classify the degree of hydrops.

摘要

通过静脉注射单剂量钆对比剂和磁共振三维液体衰减反转恢复序列(3D-FLAIR MRI)来研究耳源性眩晕患者内淋巴的可视化情况,并进一步评估内淋巴积水的程度。选取2017年10月至2018年6月首都医科大学附属北京同仁医院的30例单侧耳源性眩晕患者(男16例,女14例),年龄30~68岁,平均年龄(53±10)岁。30例患者静脉注射单剂量(0.1 mmol/kg体重)钆喷酸葡胺(Gd-DTPA)8小时后,行3D-FLAIR序列扫描。观察内淋巴积水的部位,然后由两名放射科医生对积水程度进行定量评估。采用一致性检验分析两名放射科医生对内淋巴积水部位和程度的评估结果,采用配对t检验比较耳源性眩晕患者患侧和健侧内淋巴间隙的差异。30例患者中,钆分布于内耳内所有部位的外淋巴中,且能准确勾勒出外淋巴和内淋巴的边界。26例患者(26/30,86.7%)发现有单侧内淋巴积水,其中轻度积水18例,重度积水8例。两名放射科医生对内淋巴积水的评估一致性良好(κ=0.864,ICC=0.959)。在26例有内淋巴积水的患者的3D-FLAIR MR图像中,球囊积水发生率(26/26,100%)高于耳蜗和椭圆囊(16/26,61.5%;14/26,53.8%),两名放射科医生对内淋巴积水部位的评估一致性良好(κ=0.820)。此外,本研究中内淋巴间隙患侧和健侧区域间存在显著统计学差异(P<0.01)。通过静脉注射单剂量钆进行3D-FLAIR MR成像技术是可行的,可评估耳源性眩晕患者的内淋巴积水情况,并准确分级积水程度。

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